The attachment of soft tissue to bone remains an important part of the practice of orthopedic surgery. The surgeon's armamentarium for attaching ligaments, tendons, or other tissues to bone includes pullout suture techniques, keyhole techniques, smooth or barbed soft tissue staples, and fixation with screws and washers. Each of these devices and techniques has advantages and disadvantages, depending on the surgical situation and the clinical application. The development of suture anchors, which has revolutionized soft tissue fixation to bone, has paralleled the development of arthroscopic surgical techniques. Suture anchors have been used successfully for rotator cuff repairs, shoulder reconstructions for instability, the repair of biceps anchor lesions (e.g., superior labrum anterior posterior (SLAP) lesions), and biceps tenodesis. The continuing evolution of suture anchors has produced a variety of types, such as absorbable, non-absorbable, screw-in, hooked, and knotless anchors and tacks, as well as those that lock into the bone on insertion.
Traditionally, the suture attachment to the soft tissue is secured via a knot made in the suture. In order to convey this type of procedure, a number of steps are required to complete this process. This process is as follows; 1) the bone is bored out and the suture anchor is deployed and secured in to the bone; 2) a surgical instrument or device such as a lasso is inserted through a second surgical port and pierces through the soft tissue; 3) a looped end wire is pushed out of the tip of the surgical instrument or device; 4) the looped end wire is then pulled out of the first suture anchor insertion port using a grasper; 5) one of the sutures is passed through the looped end wire out of the first suture anchor insertion port; 6) the looped end wire is then pulled back out of the second surgical port and sequentially pulls the suture out of the second surgical port; 7) a grasper is then inserted through the first suture anchor insertion port and pulls the suture back out of the first suture anchor insertion port; and 8) the two suture ends are then tied out of the first suture anchor insertion port and pushed down to secure the soft tissue to bone.
However, there is a clinical need for reducing the number of steps and operating time in soft tissue fixation to bone. Unfortunately, existing designs require too many steps, have relatively long operating times, and require a surgical instrument or device such as a lasso to pass a suture end through soft tissue.
For example, U.S. Pat. No. 5,697,950 describes a method and apparatus for facilitating use of a threaded suture anchor in combination with a cannulated anchor driver. The device enables a suture anchor to be preassembled with a suture so that a user need not assemble a suture anchor with suture immediately prior to use. Similarly, U.S. Pat. No. 5,993,459 describes a method and suture anchor installation system that includes a suture anchor, a loading unit, and a suture anchor installation tool. However, these methods require the use of an external instrument to pass the suture through tissue.
U.S. Pat. No. 7,875,042 describes a suture anchor loader comprises a housing with a port. On the other hand, U.S. Patent Application Publication No. 2010/0268274 describes a suture anchor member manual loading device that may include a body comprising first and second portions preventing the operator contact with a tip of a needle. In addition, U.S. Patent Application Publication No. 2011/0071551 describes a soft tissue repair system that includes a sheath, and an actuator. However, all these methods still require the use of an external instrument to pass the suture through tissue. This greatly increases the time, complexity, and risk during the fixation procedure.
Thus, there is a need in the art for an improved device and method for attachment of soft tissue to bone, which reduces the number of steps required for effective fixation. The present invention satisfies this unmet need.